Cutaneous Manifestations of Lyme Borreliosis in Children-A Case Series and Review

The occurrence of skin lesions is the earliest symptom of Lyme disease, and the diagnosis of these lesions and appropriate treatment may prevent complications of the disease, which are mainly neurological. The cutaneous presentation in borreliosis is heterogeneous. There are typical lesions that constitute the basis for the diagnosis of Lyme disease, and atypical ones, which cause significant diagnostic difficulties especially when the patient does not remember the tick bite. This study aims to describe the heterogeneous skin symptoms of Lyme borreliosis, as well as offer a practical approach for the recognition of the disease. Based on pediatric cases from clinical practice, rare cutaneous presentations of Lyme disease at various stages of illness and therapy are presented. Diagnostic recommendations for recognizing individual forms are discussed.

Anti-N-methyl-D-aspartate receptor encephalitis in a 17-year-old girl – a case report

Autoimmune encephalitis is rare in children and develops as a manifestation of a parainfectious or paraneoplastic syndrome. The disease is characterised by a sudden or subacute onset and a broad spectrum of neurological and/or psychiatric disorders. We present a case of a 17-year-old girl with anti-N-methyl-D-aspartate receptor encephalitis. The patient was admitted to hospital in a severe condition, unconscious, with injuries indicating a recent status epilepticus. Previous infection was found to be the most likely causative factor. Antiviral, antibacterial, immunosuppressive and anticonvulsant treatments were used with good outcomes. The aim of the paper is to point out the need to include autoimmune processes in the differential diagnosis of neuroinfections in children, which will allow for prompt implementation of appropriate treatment and improve prognosis.